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DR. SALLY JEAN SMITH M.D.
NPI 1104971746
Pediatrics in Ventura, CA

Active since January 24, 2007PECOS Enrolled
2755 LOMA VISTA RD, VENTURA, CA 93003(805) 477-9922(805) 477-9937 Get Directions Write a Review

NPPES record last updated: July 24, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 24, 2023, Jul 3, 2023, Feb 1, 2021 (3 updates tracked since 2021).

About Dr. Sally Jean Smith M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SALLY JEAN SMITH M.D. (NPI 1104971746) is an individual pediatrics provider in Ventura, California, licensed in California (C51395) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104971746
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. SALLY JEAN SMITHCredential: M.D.
Location Address2755 LOMA VISTA RDVentura, CA 93003-1544
Mailing Address2755 Loma Vista RdVentura, CA 93003-1544 · (805) 477-9922 · Fax (805) 477-9937
Phone(805) 477-9922
Fax(805) 477-9937
Sole ProprietorNo
Enumeration DateJanuary 24, 2007
Last NPPES UpdateJuly 24, 20233 updates tracked since enumeration
NPPES CertifiedJuly 24, 2023
✔ NPI 1104971746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · C51395
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2755 LOMA VISTA RD, Ventura, CA 93003
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Sally Jean Smith M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sally Smith reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Memorial Health System
Same address
Multi-Specialty
2705 LOMA VISTA RD STE 205
Ventura, CA 93003
  • Reassigned Medicare billing, California enrollment
  • 267 clinicians in this Medicare group
NPI 1720673932 (805) 667-2801

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93003 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$95.28 typical visit price
range $62.32 – $185.36
Typical copayment $23.82 (range $15.58 – $46.34)
Most-billed visit code 99203
Established Patient
$108.74 typical visit price
range $20.68 – $151.85
Typical copayment $27.18 (range $5.17 – $37.96)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEAN W. SMITH, MD., A MEDICAL CORPORATION
Family Medicine (Adult Medicine)
2755 LOMA VISTA RD
VENTURA, CA 93003
Ventura County (805) 477-9922
DR. DEAN WALTER SMITH M.D.
Family Medicine
2755 LOMA VISTA RD
VENTURA, CA 93003
Ventura County (805) 477-9922
WILLIAM T KLOPE MD INC A MEDICAL CORPORATION
Urology
2755 LOMA VISTA RD
VENTURA, CA 93003
Ventura County (805) 641-3689
HARBOR FAMILY AND PEDIATRIC MEDICAL
Specialist
2755 LOMA VISTA RD
VENTURA, CA 93003
Ventura County (805) 477-9922
DR. WILLIAM T KLOPE MD
Urology
2755 LOMA VISTA RD
VENTURA, CA 93003
Ventura County (805) 641-3689

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sally Smith's NPI number?

The NPI number for Sally Smith is 1104971746. It was assigned to this individual provider in the NPPES registry on January 24, 2007.

Where is Sally Smith located?

Sally Smith practices at 2755 Loma Vista Rd, Ventura, CA 93003. The listed phone number is (805) 477-9922.

What is Sally Smith's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Sally Smith enrolled in Medicare?

Yes. Sally Smith is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Sally Smith's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sally Smith reassigns Medicare benefits to Community Memorial Health System (Ventura, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sally Smith's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Sally Smith was last updated on July 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.